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港口相关菌血症与儿科血液肿瘤患者的微生物特征。

The Profile of Microorganisms Responsible for Port-Related Bacteremia in Pediatric Hemato-Oncological Patients.

机构信息

Department of Health Promotion, Poznan University of Medical Sciences, Poznań, Poland.

Institute of Human Genetics Polish Academy of Sciences, Poznań, Poland.

出版信息

Cancer Control. 2020 Jan-Dec;27(1):1073274820904696. doi: 10.1177/1073274820904696.

Abstract

Patients with pediatric cancer face an increased risk of infections. In most cases, these infections are associated with the use of a long-term central venous catheter. This study describes the epidemiology of a port-associated bacteremia as well as a profile of microorganisms responsible for port-associated bloodstream infections (PABSIs) in pediatric patients with cancer treated in a single center. The retrospective analysis included patients with cancer who had implanted a port, hospitalized between 2010 and 2015 at the Department of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences. The medical records of patients were reviewed for demographic characteristics, diagnosis, port-related complications, and their management. Data were collected from patients' electronic medical records containing complete information on medical examinations and supplementary tests, diagnosis, timing, and type of port-associated complications. In a study period, 277 ports were inserted to 241 patients. A total of 183 094 catheter days were analyzed. Sixteen patients had more than 1 insertion of a port. The commonest observed complication was PABSI (40.07%) and the incidence density was 0.6 per 1000 port-days. was the most commonly isolated organisms from patients with PABSI. From all port-associated complications, bloodstream infections and mechanical complications were the most often observed complications. The commonest pathogens responsible for PABSI were coagulase-negative staphylococci. Pathogens resistant to standard antibiotic treatment play an important role in PABSI, with methicillin-resistant being the predominant pathogen. Port-associated bloodstream infections are a common reason for preterm removal of a port.

摘要

儿科癌症患者面临感染风险增加。在大多数情况下,这些感染与长期使用中心静脉导管有关。本研究描述了在单个中心接受治疗的癌症患儿中,与带管相关的菌血症的流行病学以及导致带管相关性血流感染(PABSI)的微生物特征。回顾性分析包括在 2010 年至 2015 年期间在波兹南医科大学儿科肿瘤学、血液学和骨髓移植科植入中心静脉导管的癌症患者。对患者的医疗记录进行了审查,以了解人口统计学特征、诊断、与导管相关的并发症以及其处理情况。数据是从患者的电子病历中收集的,这些病历包含了完整的体检和辅助检查信息、诊断、导管相关并发症的时间和类型。在研究期间,为 241 名患者共植入了 277 个导管,共分析了 183094 个导管日。16 名患者的导管插入次数超过 1 次。最常见的观察到的并发症是 PABSI(40.07%),发病率密度为 0.6 每 1000 导管日。从患有 PABSI 的患者中分离出的最常见的病原体是 。在所有与导管相关的并发症中,血流感染和机械并发症是最常见的并发症。导致 PABSI 的最常见病原体是凝固酶阴性葡萄球菌。对标准抗生素治疗耐药的病原体在 PABSI 中起着重要作用,其中耐甲氧西林的 是主要病原体。与导管相关的血流感染是提前取出导管的常见原因。

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